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CAM > 3. Roecker - Ventilation Devices > Flashcards

3. Roecker - Ventilation Devices Flashcards

1
Q

When is ventilation used?

A

Acute respiratory failure

Adjuncts to other therapies or diagnostic procedures to avoid complications

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2
Q

What are the two categories of acute respiratory failure?

A
  1. Hypoxemic - O2 sats is 50mmHg
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3
Q

What are the 3 goals of therapy of acute respiratory failure?

A
  1. Decrease metabolic burden of breathing
  2. Prevent respiratory muscles fatigue
  3. Keep patient alive
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4
Q

What are 5 causes of hypoxemic respiratory failure?

A
  1. Acute respiratory distress syndrome
  2. Heart failure w/ pulmonary edema
  3. Infections causes
  4. Procedure complications
  5. Trauma
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5
Q

What are 3 causes of hypercarbic respiratory failure

A
  1. Coma
  2. COPD exacerbations
  3. Neuromuscular diseases
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6
Q

Ventilation is adjunctive therapy for…

A
  1. Increased intracranial pressure
  2. Endoscopy
  3. Gastric lavage
  4. Prevention of respiratory failure during critical illness
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7
Q

When is non-invasive ventilation used?

A
  1. Effective in pts w/ COPD exacerbations

2. Complications of pneumonia or tracheolaryngeal trauma avoided

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8
Q

What are 4 contraindications of non-invasive ventilation?

A
  1. Cardiac/respiratory arrest
  2. Severe encephalopathy
  3. Hemodynamic instability
  4. High-risk for aspiration
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9
Q

When is a pocket mask used?

A

For mouth to mouth resuscitation in non-breathing patients in a code situation

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10
Q

When is a bag-valve mask used?

A

To provide oxygen/air to non-breathing patient in a code situation
The squeeze bag to give air to an unresponsive pt

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11
Q

What are the 2 airway adjuncts? What is their purpose?

A
  1. Oropharyngeal airway (OPA)
  2. Nasopharyngeal airway (NPA)
    Opens the airway to get air down to lungs, does not involve putting a tube down the pts throat
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12
Q

What dose an oropharyngeal airway do?

A

Keeps tongue out of the way and gets air down to the lungs

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13
Q

What does the nasopharyngeal airway do?

A

Goes up though the nose, then down though the nasal passage to get air in the body

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14
Q

What are the 4 advanced airways?

A
  1. Laryngeal mask airway
  2. Combitube
  3. Endotracheal tube
  4. Tracheostomy tube
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15
Q

What is a laryngeal makes airway?

A

Inserts to a specific depth and inflate a cuff to isolate air down trachea and not esophagus

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16
Q

What is a combitube?

A

Two separate tubes, a blind insertion, then inflate both cuffs.
If tube ends up in esophagus, balloon blocks off esophagous
If tube ends up in tranches, good!

17
Q

What is an endotraceal tube?

A

Similar to a combitube, but requires visualization of vocal cords with laryngoscope - most commonly seen for pts on long term ventilation.
Think of Grey’s Anatomy

18
Q

What is a tracheostomy tube?

A

A surgical procedure is needed, bypass the pharynx and then directly ventilate

19
Q

What kind of air is needed for mechanical ventilation?

A

Conditioned, warmed, oxygenated, and humidified air

20
Q

What is the goal of mechanical ventilation?

A

Optimize oxygenation while avoiding damage to lung tissue, over stretching and ventilation-induced lung injury

21
Q

How is total volume used in ventilation?

A

Size of each ventilation, amount of air put into the lungs

22
Q

What is ventilator rate?

A

Timing of each ventilating, providing the pt with a respiratory rate

23
Q

What is FIO2?

A

Fraction of inspired oxygen; amount of oxygen given to the pt to keep their O2 levels up

24
Q

What is PEEP level?

A

Positive end-expiratory pressure - enough pressure to keep lungs open at end of expiration
Used to keep lungs inflated so oxygen exchange can occur in blood

25
Q

What is I/E ratio?

A

Inspiratory-to-expiratory time ratio; how much time going in vs how much time going out. Usually 1:2

26
Q

What is VE?

A

Minute ventilation - product of tidal volume and ventilator rate

27
Q

What is ABG?

A

Acid-blood passes to measure PaO2 and PaCO2

28
Q

What are the 6 ventilator modes?

A
  1. Assist control (AC)
  2. Intermittent mandatory ventilation
  3. Pressure support ventilation (PSV)
  4. Pressure control ventilation (PCV)
  5. Inverse ratio ventilation (IRV)
  6. Continuous positive airway pressure (CPAP)
29
Q

When is mechanical ventilation needed?

A

When an individual cannot adequately oxygenate with their own respirations

30
Q

When is assist control ventilation used?

A

Most often used when a pt is first started on ventilation.

31
Q

How does assist control ventilation work?

A

Ventilation is initiated by patient or the machine if specified has passed. The rate and volume is defined by the clinician.

32
Q

What are some A/E of assist control ventilation?

A

Hyperinflation or respiratory alkalemia if inappropriately monitored

33
Q

How does intermittent mandatory ventilation work?

A

Synchronous IMV coordinates the mandatory breaths to the patient breath (if present). Only a pre-set number of breaths will be assisted and controlled

34
Q

How does pressure support ventilation work? Who tolerates this the best?

A

Pressure from ventilator is only provided when an inspiratory effort is seen from the patient. Well tolerated by those being weaned off of ventilators.

35
Q

How does pressure control work. When is it to be used?

A

Works by allowing a specific amount of pressure on inspiration. Good to use where limited pressures are necessary and pt needs peak airway pressures to stay low.

36
Q

How does inverse ratio ventilation work? When it is used?

A

Uses longer inspiratory time and shorter expiratory time, will change the I/E ratio. Used to potentially open collapsed alveoli when augmented w/ appropriate PEEP levels.

37
Q

What is continuous positive airway pressure?

A

Constant pressured provided only on inspiration to keep the pts airway open.

38
Q

What are 4 potential complications from mechanical ventilation?

A
  1. Barotrauma - pressure and volume causing dissenting or damage to lung tissue
  2. Nosocomial pneumonia - hospital acquired pneumonia
  3. Stenosis - trauma from incubation
  4. Decondition of respiratory muscles - loose respiratory muscle tone if on ventilation for too long, will need to wean lungs off ventilation
39
Q

What is a spontaneous breathing trial and when is it utilized?

A

For pts who are potentially ready to be weaned off of a ventilator. Will turn off ventilation, then see how pt responds. For use to test pt before taking all the tubes out.

CAM (4 decks)

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